Provider Demographics
NPI:1811777485
Name:VELEZ, EDNA MARIE
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:MARIE
Last Name:VELEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1769 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-1717
Mailing Address - Country:US
Mailing Address - Phone:440-444-6931
Mailing Address - Fax:
Practice Address - Street 1:1769 E 30TH ST
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-1717
Practice Address - Country:US
Practice Address - Phone:440-444-6931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker